Speaker 1: Welcome to another episode of Between Us Doctors. I'm doctor
Speaker 1: Terry bro I'm doctor Robert Schor. Okay, listen, rob I
Speaker 1: want to talk to you about something that's been disturbing
Speaker 1: me for the last two weeks. Ever since I watched
Speaker 1: the oscars, I realized that there's like a new epidemic
Speaker 1: in this world. And you know what it is.
Speaker 2: What's the epidemic?
Speaker 1: Anarexia ozempica. I kid you not. It's like medically induced
Speaker 1: appetite suppression. It's like chemical starvation. People are taking these
Speaker 1: GLP one drugs to the next level, and it's like
Speaker 1: a very significant misuse. It's almost like enabling an eating disorder.
Speaker 1: Have you noticed this in your patience?
Speaker 2: Yeah, it's a it's a I'm noticing it not only
Speaker 2: in my painations, but all over society and people that
Speaker 2: I know. It's it's taking it's basically now making biochemical
Speaker 2: eating disorder possible. Yeah, it's I mean, it's it's taking
Speaker 2: it beyond weight loss to drug induced malnutrition.
Speaker 1: Yeah, anorexia ozampica. Let's let's let's talk about what it's not.
Speaker 1: This is not anorexia nervosa. This is not a psychiatric disorder.
Speaker 1: This is a medically induced eating disorder that I think
Speaker 1: is a giant problem that I'm seeing article after article,
Speaker 1: podcast after podcasts about celebrities talking about how they're misusing
Speaker 1: these drugs and they don't have any medical education indication
Speaker 1: for them, and they're getting access to them through the internet.
Speaker 1: I mean, this is a crazy, crazy problem.
Speaker 2: It's it's it's a system that has now bypassed all
Speaker 2: the medical safeguards that we normally have in the society,
Speaker 2: where if you wanted to get on a prescription drug,
Speaker 2: you'd have to see a doctor, there would have to
Speaker 2: be some reasonable indication for it, there would be someone
Speaker 2: monitoring what you're doing. This is just literally going on
Speaker 2: a website or going in the gray market and just
Speaker 2: buying these things that are potentially dangerous medications, and people
Speaker 2: are just using them as they see fit. These drugs
Speaker 2: aren't designed aren't designed for you to lose five pounds.
Speaker 2: They're designed to treat diabetes and for major weight loss
Speaker 2: in people who are obese.
Speaker 1: Right, but let's first state make a statement like this.
Speaker 1: I think this is among if not the most significant
Speaker 1: medical breakthrough in the history of medicine. These drugs are amazing.
Speaker 1: It's not the drugs that are the problem. It's the
Speaker 1: rampant misuse of these drugs that are the problem, don't
Speaker 1: you agree.
Speaker 2: Yeah, absolutely, I mean that's like most drugs, really, it's
Speaker 2: you know, it's it's like someone taking a blood pressure
Speaker 2: drug because they don't want to be one twenty over eighty,
Speaker 2: they want to be one hundred over sixty. It's not
Speaker 2: what the drug is designed to do, and it's never
Speaker 2: been tested for these things. The way people are using it.
Speaker 1: Right, it's like we're going back in time to the
Speaker 1: early two thousands when extreme thinness was a thing. Remember that,
Speaker 1: it was like the thinner you are, the better it is,
Speaker 1: when in fact, extreme thinness is actually a metabolic disorder
Speaker 1: in and of itself.
Speaker 2: It's not healthy. In other words, people are taking this
Speaker 2: to drug that's designed to improve your health and that
Speaker 2: are amazing for improving health when they're used properly, and
Speaker 2: using it in a state where they're already healthy, to
Speaker 2: drive them to a point where they're no longer healthy.
Speaker 1: By the way, it's having the opposite effect. It's actually
Speaker 1: making you look older, okay, it's actually giving you fatigue,
Speaker 1: it's giving you electrolyte disorders, it's you're losing muscle and bone.
Speaker 1: But actually, let's get a little bit not nerdy, but
Speaker 1: a slightly doctory for a minute and talk about the
Speaker 1: problem with the misuse of these drugs. Okay, because when
Speaker 1: they're used properly and you maintain your muscle mass, they
Speaker 1: cure metabolic disorders. Okay, they're fabulous for obesity, they're fabulous
Speaker 1: for all sorts of indications. But when used in the
Speaker 1: way that I'm seeing it with this anorexia ozempica, this
Speaker 1: is the fundamental problem I'm seeing. You lose muscle mass,
Speaker 1: the most important structural component of the body. And when
Speaker 1: you lose muscle mass, what happens is your metabolic rate
Speaker 1: goes down, right, And so as your metabolic rate goes down,
Speaker 1: then your body goes into this conservation adaptation mode where
Speaker 1: it's basically adapting to starvation, and that leads to a
Speaker 1: whole bunch of problems in and of it.
Speaker 2: It leads to both short term and long term problems.
Speaker 2: I mean short term. These people are walking around probably
Speaker 2: dehydrated right at least acutely malnourished. They're not getting atticause.
Speaker 2: It's very hard when you're using these medications this way
Speaker 2: to take in adequate calories every day, because really, these
Speaker 2: people are not meant to be These are not obese people.
Speaker 2: They should not be living on say a thousand calories
Speaker 2: or less per day. But it can be a challenge
Speaker 2: to get in you know, depending on your man woman,
Speaker 2: what size you are, I don't know, fifteen one hundred
Speaker 2: to twenty two hundred calories, it can be difficult on
Speaker 2: these medications.
Speaker 1: Practical examples of this their Doo Brooks Natter is the
Speaker 1: model Yeah so yeah, yeah, so very attractive, Okay, but
Speaker 1: actually talked a lot about the fact that she was
Speaker 1: using and abusing these drugs the point where she was
Speaker 1: throwing up, she was fatigued. She I think she passed out,
Speaker 1: and furthermore, you know, it leads to thinning of the hair,
Speaker 1: electrolyte disorders, you can't sleep, hormonal disruptions.
Speaker 2: By flaky skin, all kinds of things that, aside from
Speaker 2: the health issues, are just unattractive.
Speaker 1: Yeah, menstruation problems. I mean, this is a disaster phenomenon
Speaker 1: that no one is talking about, and I think it's
Speaker 1: really important that we, for at least a moment or two,
Speaker 1: highlight how to use these things properly, the red flags
Speaker 1: that you need to look for when you're using these things,
Speaker 1: and how to avoid this new newly recognized eating disorder
Speaker 1: that's clearly going from endemic in you know, the major
Speaker 1: metropolitan areas to becoming an epidemic throughout the country. Right, So,
Speaker 1: what are the factors that you need to look for
Speaker 1: when you're concerned about anorexia ozempica? I think number one
Speaker 1: is you're on these drugs and you're losing weight too rapidly, right,
Speaker 1: Number one, you shouldn't be losing one to two percent
Speaker 1: of your body weight per week. It should be more
Speaker 1: like a quarter to half percent a week.
Speaker 2: True at most, particularly if you're someone who's not obese
Speaker 2: to begin with. First of all, if you're getting on
Speaker 2: these medications to you know, lose ten pounds, you know, look,
Speaker 2: people are gonna do it. It's just gonna happen because
Speaker 2: it's it's like an easy cheat code for losing weight.
Speaker 2: It takes away the cravings and you'll do it. But
Speaker 2: if you're doing it at that point, you've got to
Speaker 2: be really really careful. You don't have that much room
Speaker 2: to play with, you know, if you're not If you're
Speaker 2: one hundred pounds overweight, then you've got huge fat stores
Speaker 2: that your body can start working off of. But for
Speaker 2: the average person who's just trying to lose a few pounds,
Speaker 2: you don't have that. And so if you get on
Speaker 2: these medications, your body is immediately going to start getting
Speaker 2: more of its calories because you're not taking in enough.
Speaker 2: It doesn't have enough fat to do that. It's gonna
Speaker 2: start breaking down muscle and healthy lean tissue immediately immediately.
Speaker 1: So the number two red flag for me is zero appetite.
Speaker 1: I mean, I've gone out with couples that I know,
Speaker 1: the women and maybe some of the men are taking
Speaker 1: these drugs and they're eating literally nothing. The goal is
Speaker 1: not to eat nothing, okay, And as I always say
Speaker 1: to Heather, you know, it doesn't look good to be
Speaker 1: that thin, I always say to her, And this is grotesque,
Speaker 1: but I'm gonna say it anyway. No one wants to
Speaker 1: fuck a skeleton, Okay. If you're doing this to look good,
Speaker 1: all right, it's having the opposite effect. So zero appetite
Speaker 1: is not the goal.
Speaker 2: No, it's well aside from it just not being the goal.
Speaker 2: If you're not look, if you're going to be on
Speaker 2: these drugs and you don't want it. First of all,
Speaker 2: you don't want to get ridiculously lean. The goal is
Speaker 2: not to have the body fat of a bodybuilder who's
Speaker 2: about to enter competition. Bodybuilders don't do that. They lean
Speaker 2: down right before the competition. They don't get down to
Speaker 2: like single digit body fat levels and live at that
Speaker 2: because it's unhealthy. It's not doable, and frankly, for everyday purposes,
Speaker 2: particularly in women, it doesn't look good.
Speaker 1: I mean, I don't know if you watch the Oscar
Speaker 1: Red Carpet, but I mean it. And I don't want
Speaker 1: to body shame anyone. I think they're all very beautiful obviously,
Speaker 1: and they're very talented, but I mean, you know, in
Speaker 1: the middle of watching the Red Carpet, I thought to myself,
Speaker 1: what is this the ozempics or is this the oscars?
Speaker 1: You know what I mean? I mean, I just think
Speaker 1: people are taking this too far, okay, And if the
Speaker 1: other red flag is you're just not eating enough protein,
Speaker 1: this is really all about muscle wasting and protein. And
Speaker 1: what do you tell your patients how many grams poor
Speaker 1: kilogram or body pound should they eat in protein?
Speaker 2: Well, if they're going to be on this at least
Speaker 2: one and probably about one point five in reality. So
Speaker 2: I would recommend to anyone who's taking this, first of all,
Speaker 2: if you're going to be taking these, see your doctor
Speaker 2: and get it prescribed properly and be monitored for this.
Speaker 2: You need to have labs check periodically. You need to
Speaker 2: be looked at. And a lot of these telem medicine
Speaker 2: sites that do this, yeah, they're kind of getting around
Speaker 2: because there's a doctor that you get on a zoom
Speaker 2: call with and they make you fill out a questionnaire.
Speaker 2: That's not really that's not really medicine. Let's not get
Speaker 2: ourselves medicine to get on one of these medications, particularly
Speaker 2: for questionable goals. You need to see someone. They need
Speaker 2: to a physical exam on you. You need to get some
Speaker 2: labs done, You need to make sure that this isn't
Speaker 2: that first of all, you're in the right state of
Speaker 2: health to start it, and someone needs to be monitoring
Speaker 2: this as you go. And then you need to be
Speaker 2: supplementing your protein and you need to be lifting weights.
Speaker 2: You need to be doing strength training minimum of two
Speaker 2: times a week to maintain or you are going to
Speaker 2: lose muscle mass and you're going to get weaker, and
Speaker 2: as that happens, your metabolic rade is going to drop.
Speaker 2: So good luck getting off of these medications. Afterwards, when
Speaker 2: you've been in a starvation mode for a long time,
Speaker 2: you're going to start gaining weight very rapidly. So, now,
Speaker 2: by the way, stock on these meds. That's exactly the point.
Speaker 2: That is an a super important point. If your metabolic
Speaker 2: rate goes down too quickly and you get off these drugs,
Speaker 2: you're going to have such rapid gain regain that it's
Speaker 2: just going to rebound horribly for you. So the act
Speaker 2: opposite of what you want to maintain is what happens. Now,
Speaker 2: let's talk about this whole thing with rediitruy tide. Okay. Yeah.
Speaker 1: The problem is is that whether we like it or not,
Speaker 1: whether we suggest that people should be on medical supervision,
Speaker 1: have the proper indications, whether BMI grader than thirty or
Speaker 1: greater than twenty seven with a COMORBIDITI like hypertension, blah
Speaker 1: blah blah, all those doctory things that you or I
Speaker 1: would say. At the end of the day, we have
Speaker 1: to acknowledge people are going to get these from compounding pharmacies. Okay,
Speaker 1: they're just going to do it. So I think it's
Speaker 1: better for us to acknowledge that they're going to get
Speaker 1: them this way and at least give some advice that
Speaker 1: if you are going to get on REHDTA, this is
Speaker 1: how you should do it. The problem is, if you
Speaker 1: haven't heard about Rihtta or Rehta truetide. It's one of
Speaker 1: the most amazing phenomenons I've ever seen in medicine where
Speaker 1: a drug that's not even FDA approved yet not even
Speaker 1: been proven to be safe, is one of the most
Speaker 1: powerful and popular drugs that people are using to induce
Speaker 1: this medical starvation. It's so easy to get and all
Speaker 1: you have to do is get near talk about Rehtta
Speaker 1: near your phone, and the next time you scroll mindlessly
Speaker 1: on your phone, it's going to show you no nothing
Speaker 1: but Jim Brow's chiropractors and high school grads talking about
Speaker 1: the medical indications for these drugs REDDA. But let's talk
Speaker 1: about what REDDA is, because I think we have to
Speaker 1: acknowledge people are just going to use this REDDA even
Speaker 1: before Eli Lilly approves this drug. We don't want you to.
Speaker 2: Yeah, but what is if you're hitting on I think, well,
Speaker 2: I think you're hitting on something really important here, aside
Speaker 2: from just the health risks of being on these drugs
Speaker 2: in a non prescribed, just experimental way, is the situation
Speaker 2: we have now is going to break the pharmaceutical industry
Speaker 2: in this country if it continues. And look, I'm no
Speaker 2: fan of big pharma, but everyone and his brother is
Speaker 2: making money off of REDDA true Tide now except Eli Lilly,
Speaker 2: who can't make any money off of it, which is
Speaker 2: the company that developed a drug. So if we start
Speaker 2: doing this with every promising medication that comes out, where
Speaker 2: immediately compound pharmacies are selling it and everyone is selling
Speaker 2: it online. I think waiters are slipping it in my
Speaker 2: food now at meals. You know, it's it's like it's
Speaker 2: it's it's it's just ubiquitous. Right. It's like everyone but
Speaker 2: the actual intellectual property owner of the medication is making
Speaker 2: money off of it. There's no way Eli Lilly is
Speaker 2: gonna sit still for this.
Speaker 1: Well, it's crazy because what's going to encourage them to
Speaker 1: make the two billion dollar investment to get these things
Speaker 1: it proved. But let's let's for those who don't know,
Speaker 1: let's talk about quickly what Retitruetide is. Okay, so just
Speaker 1: very very briefly, as you know, ozempic is GLP one.
Speaker 1: That's ozempic and govi. Okay, that's the first proc. The
Speaker 1: single agonist it's called manjarro and zep bound are GLP
Speaker 1: one and GIP. Those are two hormones naturally found in
Speaker 1: the body. And then the big breakthrough with retitrue tide
Speaker 1: is it's a triple agonist. It's not only GLP one,
Speaker 1: it's GIP and it's a glucagon rect agonist. Okay, So
Speaker 1: ideally it fat burns. Ideally it preserves theoretically muscle mass.
Speaker 1: We're hoping that it does all this safely. We don't
Speaker 1: know because it's not FT approved, but it's so powerful
Speaker 1: and I think it's going to be the first trillion
Speaker 1: dollar drug. But I bet you there are more people
Speaker 1: on illegal, unapproved, unsafe who knows where it came from
Speaker 1: retitruetide than probably almost any other drug out there.
Speaker 2: Yeah, and that's probably true for most people taking the
Speaker 2: golp ones as well. It's they're on really questionably sourced drugs.
Speaker 2: And so because if you're not getting it from the manufacturer,
Speaker 2: you're getting it from a compounding pharmacy that either makes
Speaker 2: it here domestically, or more likely it's being made in China.
Speaker 2: So aside from the fact that one, you're using this
Speaker 2: in a way that it wasn't designed to be used,
Speaker 2: that it hasn't been tested for it all these PEO
Speaker 2: people creating their own dosing regimens. Okay, that's you're running
Speaker 2: the experiment on yourself, basically. Yeah. But also, but aside
Speaker 2: from the fact just the you're taking something a drug
Speaker 2: that's not the design for the purpose you're using it for.
Speaker 2: You're using it in doses that it's never been tested for.
Speaker 2: You're getting on and off of it, which is probably
Speaker 2: even worse for muscle loss over the long run. In
Speaker 2: addition to that, you don't even know that you're getting
Speaker 2: the actual drug, and if it is the actual drug,
Speaker 2: you don't know what contaminants are in it. You are
Speaker 2: literally running the experiment on yourself.
Speaker 1: Okay, So it's very clear we don't recommend you get
Speaker 1: it from a compounding pharmacy because, by the way, it's
Speaker 1: illegal for them to compound a drug that's not EFTY approved.
Speaker 1: It's illegal, unauthorized, uncool, it's actually a criminal act. But
Speaker 1: let's assume for a moment that somebody is going to
Speaker 1: get rettritide on the let's assume someone may have Yeah, okay,
Speaker 1: let's see that that's being done. Okay, lowest possible effective dose.
Speaker 1: That's point number one. Absolutely start at the lowest dose
Speaker 1: and retitrue tide because of the fat burning component, may
Speaker 1: take a little bit longer. Then we'll go via a
Speaker 1: zembic or zep bound or any other GLP one drugs
Speaker 1: to actually kick in. So the goal is not zero appetite.
Speaker 1: The goal is not for you to lose five pounds
Speaker 1: per week. The goal is to diminish your appetite. These
Speaker 1: are appetite suppressants with hopefully retitrue tide kicking in a
Speaker 1: fat burning component. So keep the dose very low. If
Speaker 1: it doesn't work for a week or two or three,
Speaker 1: that's okay. Just don't raise the dose yet because we
Speaker 1: don't know what you're injecting into yourself.
Speaker 2: Okay.
Speaker 1: By the way, you ever seen this FX show The Beauty.
Speaker 2: I don't think so.
Speaker 1: Oh, it's really good. By the way, Ashton Kutcher stars
Speaker 1: in it, and it's about this shot that you can take. Okay,
Speaker 1: Ryan Murphy's show, which turns you into like a supermodel, young,
Speaker 1: amazing version of yourself. The problem is when a version
Speaker 1: of it that got out of the lab was being used,
Speaker 1: people would literally explode and spread their guts everywhere. And
Speaker 1: I'm not saying reditruetide is the next the beauty shot.
Speaker 1: But at the end of the day, if there's something
Speaker 1: like an endotoxin, which is a viral sort of impregnated
Speaker 1: bacteria or microorganism in it that takes a while for
Speaker 1: it to manifest, we couldn't be injecting ourselves with something
Speaker 1: that could lead to a very significant for example, neurologic
Speaker 1: disease later like Kreutzfeld, Jacob Kreutzfeld, you know that one. Yeah,
Speaker 1: the matt basically the human mad cow disease, human mad
Speaker 1: cow disease. And you know, I'm not here to scare anybody.
Speaker 1: And again I'm not saying anarexia ozempica is a psychiatric disorder,
Speaker 1: but I mean we may be falling off a cliff
Speaker 1: into this unknown abyss that we're setting ourselves up for.
Speaker 1: That may be a giant problem. But having said that,
Speaker 1: let's go back to how to use this redit true tide.
Speaker 1: If you must, if you're going to okay.
Speaker 2: So we may be going off a giant, disastrous cliff.
Speaker 2: But in case, you're gonna do it anyways, but we're
Speaker 2: gonna get yeah, yeah, Well, look, I see one thing
Speaker 2: needs to be stated here, Okay, and I can. I
Speaker 2: totally understand the motivation to use these and I'm not
Speaker 2: opposed at all to using it, but I think that
Speaker 2: most people. Look, if you're gonna use it, you're gonna
Speaker 2: do these things, do it with full awareness of the
Speaker 2: risks that you're taking. And said, I have no problem
Speaker 2: if we go to this sort of model for most
Speaker 2: medications in the country. The problem is if you go
Speaker 2: to this, you're acting as your own doctor, and so
Speaker 2: at this point it's on you to educate yourself. Okay,
Speaker 2: what am I going to get out of this? It's
Speaker 2: getting my body fat percentage down to fifteen percent. Worth
Speaker 2: being on a medication where we don't know what it's
Speaker 2: going to do to us ten years from now. Because
Speaker 2: that's true for semaglue tie, that's true for all of them.
Speaker 2: The longest term studies on most of these medications in
Speaker 2: big studies is maybe four years. That's not really long,
Speaker 2: and those studies are mostly on diabetics, which is what
Speaker 2: the medications were developed for so just know that. Yeah,
Speaker 2: I see the value in looking ripped and handsome and pretty, right,
Speaker 2: but there are a lot of unknowns in this.
Speaker 1: Yeah, I think it in terms of also more practical
Speaker 1: things we can suggest. Decide on an endpoint. Okay, maybe not.
Speaker 1: You know, your your high school, your your weight when
Speaker 1: you were fifteen and you had that sudden growth spur
Speaker 1: and all of a sudden you got skinny, just biologically
Speaker 1: creat So yeah, by the way, I was totally a
Speaker 1: chubby when I was on the tennis team in high school.
Speaker 2: They gave me the Turtle Award. I was very chubby.
Speaker 2: Never heard this about you before.
Speaker 1: On a decide on what a reasonable end point is, Okay,
Speaker 1: So if if you know you're twenty pounds overweight, and
Speaker 1: that's a real twenty pounds, right, meaning you're not trying
Speaker 1: to get down to your married weight, your bridal weight,
Speaker 1: but some reasonable weight. When you hit that point, back off, okay,
Speaker 1: back off, make sure you're eating the proper protein, do
Speaker 1: your resistance training, and you know the moment Eli Lilly,
Speaker 1: for example, is able to get this FT approved to
Speaker 1: come out, maybe switch to the actual real pharmaceutical version
Speaker 1: rather than this unknown one because you know, well I know,
Speaker 1: I don't know if you know about I'm sure you do.
Speaker 1: RFK Junior has decided to decategorize fourteen of the peptides
Speaker 1: from category two, which means they're illegal, to category one,
Speaker 1: which means compounding pharmacies can actually make them legally, right,
Speaker 1: all right, that isn't that's not that hasn't been passed yet.
Speaker 1: It's still legal to get the peptides, but everybody's doing
Speaker 1: it anyway. It will never be legal to compound reda
Speaker 1: true Tide ever, because it's not FDA approved, Okay, it
Speaker 1: will never be legal to do that. So the end
Speaker 1: of the day, these drugs like Reddit True Tide are
Speaker 1: being shifted towards from the grayish market to the black market,
Speaker 1: where you know, it's the guy behind the gym with
Speaker 1: the you know, the lunch bag and the trend bologne
Speaker 1: or whatever and the you know, the test and the anavar,
Speaker 1: you know, that kind of scummy kind of sourcing of it,
Speaker 1: where they're a lot more dangerous and a lot more suspect.
Speaker 1: I mean, I'm just I'm really worried that this is
Speaker 1: going to blow up in our face. And listen, no
Speaker 1: one wants to take retitruetide more than me. Okay, I
Speaker 1: really like the idea of fat burning and controlling my
Speaker 1: appetite because I've always been victimized by my appetite. You
Speaker 1: know me, Rob, I can literally eat till I'm full
Speaker 1: and then still shove more food in. You know, I
Speaker 1: find a place in my satiety center where I'm shoving
Speaker 1: it in on just adjacent to nausea I can go.
Speaker 1: I can't tell you how many times I've woke woken
Speaker 1: up at three o'clock in the morning and you know,
Speaker 1: had to go and throw up because I've just eaten
Speaker 1: too much. I'm I can relate to those people who
Speaker 1: have no control over their app I mean, I'm the
Speaker 1: perfect person for a GLP one because for me, appetite
Speaker 1: suppression would be extraordinarily helpful. Right, But this retitruetide, I mean,
Speaker 1: I don't know at what cost? You know, what are
Speaker 1: we trading for this?
Speaker 2: First of all, it's good that you wake up before
Speaker 2: throwing up, At least from Heather's standpoint, probably that's got
Speaker 2: to be a huge plus for her. Look the goal
Speaker 2: in terms of you, it's you're looking for a little
Speaker 2: bit of appetite suppression. You're not looking to kill all
Speaker 2: of your appetite, right, So if people are taking this,
Speaker 2: the goal is to just get to the point where
Speaker 2: you have a sense of control at meals, so you
Speaker 2: can eat a sensible portion and not overeat. The goal
Speaker 2: isn't that you look at a plate of food just gough,
Speaker 2: I don't want any of it. And that's unfortunately the
Speaker 2: way a lot of people are doing this. And by
Speaker 2: the way, you know, I don't see a compelling reason
Speaker 2: at the moment to use red atruetide because you can
Speaker 2: get you know, you can get munjaro, you can get ozampic,
Speaker 2: all of these are available through prescription. You know you're
Speaker 2: getting the actual, real, pure product. And if I believe,
Speaker 2: I just heard that Costco is now doing a month's
Speaker 2: supply for about five hundred dollars, and so the price
Speaker 2: is getting into a place that's reasonable on these things.
Speaker 2: Why take something that isn't even FDA approved yet, that
Speaker 2: you can only get through backdoor channels? Why do Yeah,
Speaker 2: by the way, that we have better medication, but what
Speaker 2: we have is more than good enough at the moment.
Speaker 1: By the way, that's a really important point, because you
Speaker 1: can go to Lily dot com and get into their
Speaker 1: telehealth thing and not actually even have to go in
Speaker 1: necessarily to see a doctor answer some questions, and then
Speaker 1: get a prescription from them and go and get the
Speaker 1: real thing. Right. Yeah, So you've just.
Speaker 2: Eliminated a whole category of risk just by doing that.
Speaker 2: One that you're getting the real drug, and two that
Speaker 2: it's not filled with kind of dangerous and pure these
Speaker 2: heavy metals, all kinds of things that you don't know
Speaker 2: what you're injecting because you don't know who made this
Speaker 2: or how much they cared, or or or or exactly
Speaker 2: what you're getting. You just don't want to take gray
Speaker 2: market drugs, you know what.
Speaker 1: The other problem is the rub there are I think
Speaker 1: no less than twelve to fifteen other weight loss drugs
Speaker 1: in the pipeline that will come out, from pills to injectables,
Speaker 1: to things that cause you know, your muscles to hypertrophy,
Speaker 1: like a steroid would added on to red a true time.
Speaker 1: I mean, wonderful things are coming down the pipe, but
Speaker 1: what happens when those things are compounded before they come
Speaker 1: out and it really gets out of control? Listen, you
Speaker 1: do not want to be a guinea pig for these
Speaker 1: unknown drugs that f with your metabolic rate, that f
Speaker 1: with because the one thing that occurs, particularly in those
Speaker 1: of us who are over fifty, is there comes a
Speaker 1: point physiological where this frailty gene kind of kicks in.
Speaker 1: And you've seen people like this who are like sixty
Speaker 1: sixty three who don't work out, it, don't eat protein,
Speaker 1: and all of a sudden, they just look old. And
Speaker 1: that that's a condition of frailty that is kind of
Speaker 1: semi irreversible. Once frailty kicks in, it's very difficult to
Speaker 1: go back. But you can either delay avoid it all together,
Speaker 1: or certainly delay it by years and years by resistance training,
Speaker 1: by protein, by minimizing lean muscle mass. Oh, and the
Speaker 1: other thing when you lose muscle, minimizing loss of lean
Speaker 1: muscle mass. When you lose muscle mass, okay, your bones thin.
Speaker 2: When we were in general surgery, Okay, an older person
Speaker 2: who fell and broke their hip, and that begins basically
Speaker 2: a death spiral because they're already frail, right, because that's
Speaker 2: why they have the brittle osteophrotic bones to begin with.
Speaker 2: And then they don't have the reserve, they don't have
Speaker 2: the muscle mats. They don't have the nutrition, they don't
Speaker 2: have the health reserve to recover from this, and then
Speaker 2: they get pneumonia, and then they go downhill from there,
Speaker 2: and these people end up dying from these sort of things.
Speaker 2: So the problem with using these medical if you're using
Speaker 2: these medications as part of everything else that you're doing
Speaker 2: for your health, good diet, good sleep, exercise that includes
Speaker 2: strength training, that includes zone two cardio, that includes high
Speaker 2: intensity cardio, all the things you should be doing, then yeah,
Speaker 2: maybe as a supplement if you're using these meds to
Speaker 2: bypass doing all of that. One you're not gonna look
Speaker 2: good because you're just not gonna be healthy, you're gonna
Speaker 2: be mountain nourished, and two you're setting yourself up for
Speaker 2: premature death.
Speaker 1: In my book, well, the thing I'm worried about is
Speaker 1: it's gonna take that sentinel event. Some celebrity, some young
Speaker 1: influencer is gonna take this too far with these GLP
Speaker 1: one drugs and literally overdose to the point where they
Speaker 1: haven't eaten, they're completely malnourished, they have an electrolyte abnormality,
Speaker 1: and then a cardiac event, and then then we're all
Speaker 1: going to go, Okay, that's gonna be the wake up call.
Speaker 1: What we're hoping with this kind of message is that
Speaker 1: you don't we don't have to wait for that sentinel event,
Speaker 1: for that wake up call of some influencer celebrity.
Speaker 2: I think, if I remember correctly, Brooke Nader had an
Speaker 2: episode where her family found her passed out in like
Speaker 2: a tub full of water because she was either so malnourished,
Speaker 2: dehydrate and electrolytes out of abnormal. It's something along those lines.
Speaker 2: I don't know that they said what the reason was,
Speaker 2: but she ascribed it to being on these drugs and
Speaker 2: using them incorrectly.
Speaker 1: You know, it's funny because we're plastic surgeons and health
Speaker 1: and wellness experts and so on, but it reminds me
Speaker 1: of you know, when breast dogm first happened, when vpls
Speaker 1: first came out, when lepelsoaktion first happened. Oh this is great,
Speaker 1: and all of a sudden, you know, because of some
Speaker 1: influencer or some big celebrity pushing the envelopes. Now it's
Speaker 1: eight hundred ccs in each breast, and then it went
Speaker 1: to fifteen hundred CC's and then injecting four leaders in
Speaker 1: each butty cheek. You know this is going to go
Speaker 1: down that path of excess. There's no question about it.
Speaker 1: The question is are you going to be the person
Speaker 1: who does that or are you going to be smart
Speaker 1: and do it under medical supervision? Eat your protein, do
Speaker 1: your resistance training, check your labs. By the way, I
Speaker 1: think everybody, everyone before they go on one of these drugs,
Speaker 1: should get what a metabolic blood panel completely profile.
Speaker 2: Yeah. Yeah, and by the way, you can just there's
Speaker 2: plenty of places you can just go and get it
Speaker 2: on yourself. Now, it's not expensive, it's easy to do.
Speaker 2: And look, it's the kind of thing that if you're
Speaker 2: not going to your doctor every year and getting this done,
Speaker 2: you should be and or get it yourself. Know where
Speaker 2: you stand on these things, This isn't hard to do.
Speaker 1: One thing I noticed is, you know, every time before
Speaker 1: these drugs came out, I used to look at Leonardo DiCaprio, right,
Speaker 1: one of the great actors of our era, and you know,
Speaker 1: he's single and dates a lot of young models, and
Speaker 1: you know, because he can and so on. But I
Speaker 1: look at this guy on vacation in the yachts, and
Speaker 1: he's a guy hell is he like fifty years old now.
Speaker 2: Something around there? All right, But every.
Speaker 1: Time I see him on the yacht. You know, we're
Speaker 1: all allowed to gain some weight and you know, go
Speaker 1: off our diet between whatever he's doing, movies.
Speaker 2: And so on.
Speaker 1: But Leonardo DiCaprio has looked at various times pretty out
Speaker 1: of shape, pretty chunky, pretty, you know, like I'm on
Speaker 1: the carb straight diet. Have you noticed that about him?
Speaker 1: And I've always wondered Dad bod plus at least dad blood,
Speaker 1: Leonardo dad bud.
Speaker 2: Like sub average dad. And look, right, I don't want
Speaker 2: to crap on Leonardo DiCaprio. I wish I looked like
Speaker 2: Leonardo DiCaprio, even now, even at his worst, Dad bought.
Speaker 2: Leonardo DiCaprio has always been and still is, very good looking.
Speaker 2: But I think you make a really good point here
Speaker 2: is you can look at Leonardo DiCaprio's face now at
Speaker 2: fifty three or whatever he is, and you can see
Speaker 2: the hard living that he has done, the partying, whatever
Speaker 2: substances he's done, the maybe one too many nineteen year
Speaker 2: old models, maybe one too many nights up partying. All
Speaker 2: it takes its toll, Harry. It takes it's toll.
Speaker 1: It does. But at the Oscars, though Leonardo DiCaprio looked
Speaker 1: decisively thinner, he looked very glp one to me, Now
Speaker 1: he looked better, didn't you think?
Speaker 2: I think he did. I think he did. I think
Speaker 2: he definitely looked better than how he looked a few
Speaker 2: years ago, when I think he was at his doe.
Speaker 2: But you can see the consequences of the way he's
Speaker 2: lived in his face and in his body now because
Speaker 2: he looked good, he looked better than he did. He
Speaker 2: still looks great. Like I said, I would swap his
Speaker 2: life for mine, and the way he looks right now
Speaker 2: for the way I look. But on the other hand,
Speaker 2: he doesn't look anywhere near as good as Leonardo DiCaprio
Speaker 2: could look at fifty three if he had maintained his
Speaker 2: health throughout, which he obviously has not. He doesn't look healthy.
Speaker 1: Now, right, That's the problem. You can abuse yourself at
Speaker 1: twenty three and look fine at twenty five. You can
Speaker 1: abuse yourself to a certain degree at thirty three and
Speaker 1: still look okay at thirty five. Right, you abuse yourself
Speaker 1: at fifty two. I think cosmetically, esthetically you might not
Speaker 1: be able to go back to the way you used
Speaker 1: to look. And I think he's danger close to if
Speaker 1: he doesn't get his act together right, stay on the
Speaker 1: excise regimen, you know, do the GLP one drugs. If
Speaker 1: he has a medical and I mean he's look, he's
Speaker 1: had a medical indication for GLP one drugs. I'm sure
Speaker 1: as BMI was greater than twenty seven at some point
Speaker 1: was out of question. But I think Leonardo DiCaprio, you know,
Speaker 1: I think he's the most brilliant actor, but he's a
Speaker 1: good example of he's on the rapid path to maybe
Speaker 1: a Jack Nicholson type irreversibility if he doesn't get his
Speaker 1: act together, don't you think.
Speaker 2: Well, I think you can already see. And again, I
Speaker 2: you know, there's a part of me that doesn't like
Speaker 2: doing this because it's a little unfair to celebrities because look,
Speaker 2: we all get just crappier as we get older. True,
Speaker 2: but the problem for them is that, you know, there
Speaker 2: are a million pictures of me out there when I
Speaker 2: was twenty five, you know, looking way better than I
Speaker 2: do right now that people go, oh yeah, because I
Speaker 2: see this clipbait all the time. It's like, you wouldn't
Speaker 2: believe how ugly Bridget Bardow is now. I'm like she's ninety. Yeah,
Speaker 2: of course she doesn't look like she looked in nineteen
Speaker 2: sixty five. But the problem for celebrities is being in
Speaker 2: that level of the spotlight all the time. Everyone is
Speaker 2: constantly looking at you from every angle and just endlessly
Speaker 2: critiquing you. But you know, I think for you know,
Speaker 2: you make the point that you can't at such a
Speaker 2: certain age, you can't go back in others, if you
Speaker 2: do the damage, it's probably irreversible, and I think it is.
Speaker 2: But I think at any point, if you don't take
Speaker 2: care of yourself, or if you're thirty and you don't
Speaker 2: take care of yourself for a ten year span, you're
Speaker 2: paying the price regardless. Can you reverse a lot of
Speaker 2: it at forty Yeah? But are you ever going to
Speaker 2: look as good in the future as you would have
Speaker 2: looked had you just maintained everything through your whole life,
Speaker 2: kept a stable weight, maintain good health, worked out.
Speaker 1: Nope, you're not well going to think two two really
Speaker 1: good examples. George Clooney. This is a guy who takes
Speaker 1: care of himself. He may drink a bit, but he
Speaker 1: takes care of himself. He clearly keeps his weight locked in.
Speaker 1: He's very active, you know, he loves basketball. He's very fit.
Speaker 1: And Harrison Ford. I think Harrison Ford has done an
Speaker 1: amazing job at self preservation, longevity preservation, and maintenance. These
Speaker 1: are people who have gotten naturally older. But you know,
Speaker 1: you can tell that the years of over use of
Speaker 1: various things. Rather than use the word abuse, I'm going
Speaker 1: to say over enthusiastic use of those things you know
Speaker 1: when you're younger hasn't hasn't necessarily taken its toll. And
Speaker 1: you know, and obviously Tom Cruise. Tom Cruise has never
Speaker 1: let himself go.
Speaker 2: Brad Pitt, who we talked about, who we talked about
Speaker 2: on the last episode, same category.
Speaker 1: Yeah, well, Brad Pitt.
Speaker 2: I've never seen Brad Pitt looking unhealthy.
Speaker 1: No, And I think he did talk about the fact
Speaker 1: that he had some drinking issues and that he's been
Speaker 1: sober for just forever. Now. I mean, I'm not a
Speaker 1: fan of being completely sober, all right. I enjoy my
Speaker 1: intermittent cocktail, all right. And whether that has taken a
Speaker 1: toll on the way I look or not, maybe, but
Speaker 1: I'm okay with that just as long as it hasn't
Speaker 1: taken a toll on me physically, which I'm so surveilled
Speaker 1: and so monitored. I know exactly how much plaque is
Speaker 1: in my carotid arteries. You know, I know where I'm
Speaker 1: at physiologically, So I know I'm okay. But you know,
Speaker 1: maybe not everybody monitors themselves as closely as I do.
Speaker 1: Do you do you do that kind of monitoring of yourself?
Speaker 2: Your level of obsessed with monitoring? Now? No, probably you
Speaker 2: basically where you have a home, MRI. Now I don't
Speaker 2: have that. But look, you look obviously older than we
Speaker 2: met eventually the same so lean You're probably leaner and
Speaker 2: more muscular now than you were when I knew you
Speaker 2: in your twenties. So you're you know, your false modesty aside,
Speaker 2: you look, you look great, but you know you take
Speaker 2: Let's go back to Leonardo DiCaprio for second, okay, because
Speaker 2: I think this is instructive on the what it does
Speaker 2: to you when you don't maintain this. Okay. So I
Speaker 2: looked really closely at photos of him at the last oscars,
Speaker 2: and if you look at him compared to how he
Speaker 2: looked when he was younger, when he was younger, he
Speaker 2: had sort of that sort of a heart shape to
Speaker 2: his face, more fullness in his upper cheeks, less fullness
Speaker 2: and his lower cheeks and everything kind of tapered in.
Speaker 2: It was almost like a bit of a feminine face. Right.
Speaker 2: If you look at him now, he's got some fairly
Speaker 2: heavy jowling for a man of his size, and he
Speaker 2: has no fullness in his upper cheeks, which means that
Speaker 2: all the internal soft tissue of the cheeks has descended
Speaker 2: from the upper cheeks down into the lower cheeks. And
Speaker 2: it's it's fine in a man to some extent, it's
Speaker 2: you know, it looks rugged. He's starting to look like
Speaker 2: he's slowly merging with Tom Selleck so especially with the mustache.
Speaker 2: But that's a consequence of the weight changes. Yeah, gain
Speaker 2: a bunch of weight, All of the ligaments in your face,
Speaker 2: all of that tissue stretches out. When you lose the
Speaker 2: weight again, the fact goes away, some of that fullness
Speaker 2: goes away, and everything drops. So it just brings us
Speaker 2: full circle to the you gotta stay healthy. You got
Speaker 2: to maintain a stable weight, yeah, or you're gonna pay
Speaker 2: the Even someone as good looking as him, it's going
Speaker 2: to pay the price, one way or another.
Speaker 1: So at the end of the day, although we just
Speaker 1: had a whole discussion about the dangers of misuse over
Speaker 1: use of the GLP ones, and someone like him, under
Speaker 1: proper medical supervision, under proper surveillance, GLP one might be
Speaker 1: life extending, life saving, preserving his looks completely and totally
Speaker 1: and actually.
Speaker 2: A very good idea when you agree, Yeah, look, I
Speaker 2: think it may or may not be a good idea
Speaker 2: for a lot of people, you know, in that age range,
Speaker 2: our age range. You know, there are definitely there's definitely
Speaker 2: evidence that these have cardiovascular benefits. It probably has a
Speaker 2: lot of metabolic benefits. The problem is is that, you know,
Speaker 2: a little bit, at least scientifically, the jury is still out.
Speaker 2: There aren't long term studies and there's really very little
Speaker 2: in the way of studies on their youth, their use
Speaker 2: on healthy, reasonably fit people, which is a lot of
Speaker 2: the people who are using this right now, so that's
Speaker 2: completely unstudied. So, yeah, there's no question that they have
Speaker 2: longevity benefits in people who are morbidly obese or somewhat
Speaker 2: obs or you know, bm I over twenty seven. Yeah,
Speaker 2: because those people have a lot more health risks and
Speaker 2: you start losing that weight and improving metabolically, Yeah, that's
Speaker 2: gonna have benefits. But what if you have a BMI
Speaker 2: of twenty one or twenty two and you're starting out
Speaker 2: and you're completely healthy, and you're thirty years old, and
Speaker 2: you're maybe signing up to do this for the next
Speaker 2: forty years of your life.
Speaker 1: Well, you're in.
Speaker 2: You're in. You're in the study group when you may
Speaker 2: want to be in the placebo group for this study. Right,
Speaker 2: that's true, because now, let's.
Speaker 1: Be honest, certainly in Hollywood, being on a GLP one,
Speaker 1: being on REDDA, being on Monjaro at a BMI of
Speaker 1: twenty three, which is probably a female's five to seven
Speaker 1: ways what one ten is probably a BMI of twenty three.
Speaker 1: I mean, this is a person who shouldn't lose any weight.
Speaker 1: Oh and that reminds me. So you ever heard of
Speaker 1: this the Mormon Wife cast member named Layla.
Speaker 2: Yeah, I know, I know a little bit of the story.
Speaker 1: Yeah, super Thin went on one of these GLP one drugs.
Speaker 1: I mean that that really is enabling not only body dysmorphia,
Speaker 1: that's enabling an eating disorder. That's really you know, yeah,
Speaker 1: out there.
Speaker 2: I think if I remember correctly, She said she struggled
Speaker 2: with eating disorders her whole life. Right, and the last
Speaker 2: thing we need is people using these drugs to enable
Speaker 2: their known eating disorders. Right. You know, if you've got
Speaker 2: an eating disorder and you struggle with body dysmorphia and
Speaker 2: you're already very lean and you're thinking about you know,
Speaker 2: if you're in a BMI of twenty and you want
Speaker 2: to get on this to get to a BMI of
Speaker 2: eighteen or something like that, it's time to seek help.
Speaker 1: Yeah. I mean, if you're looking to get to your
Speaker 1: birth weight, that's not a great goal. Okay, that's a problem.
Speaker 2: These people are using. Some people are using this to
Speaker 2: basically treat they're eating disorder, and exactly the way you
Speaker 2: don't want to treat an eating disorder, which is by
Speaker 2: making it more effective.
Speaker 1: Yeah, I mean, it's giving a gambling addict, you know,
Speaker 1: access to a slot machine. For those in the audience
Speaker 1: that don't know, your BMI is your body mass index
Speaker 1: and it's a relationship between your height and your weight
Speaker 1: and gives you a good proxy measure of how much
Speaker 1: body fat you have and how much visceral fat and
Speaker 1: whether you should lose weight or not, and anything over
Speaker 1: thirty is considered class one obesity, over thirty five is
Speaker 1: Class two OBC, and over forty is Class three, the
Speaker 1: most severe level of obesity, and twenty five to thirty
Speaker 1: is overweight, and twenty to twenty five is sort of
Speaker 1: underweight or probably okay. And you know, you don't want
Speaker 1: to overfocus on BMI too much, but because it's not
Speaker 1: perfectly accurate, I mean, ideally someone would get it before
Speaker 1: they go on these drugs because you really want to
Speaker 1: focus on the muscle mask compartment. You get a DEXA scan,
Speaker 1: you get baseline blood panels, you go to a doctor.
Speaker 2: You have an EKG.
Speaker 1: But we know that very few people in these drugs
Speaker 1: actually do that, right.
Speaker 2: Let's see, I think the majority of people doing this
Speaker 2: the compounding route are at best getting it from some
Speaker 2: telehealth site where they've seen some on screen doctor for
Speaker 2: ten minutes, which is not I mean, it passes the test,
Speaker 2: but it's not really what you want to do, and
Speaker 2: that's probably at best. At worst, they're getting it, like
Speaker 2: you said, from the behind the gym, yeah, you know,
Speaker 2: or from whatever their local seven eleven or dry clean
Speaker 2: or whatever. Yeah, because everyone is selling reditrue Tide except
Speaker 2: you light lily. Yeah.
Speaker 1: I mean, we're gonna wrap this up, but I just
Speaker 1: want to say that, you know, with a gigantic grain
Speaker 1: of salt, when you listen to these Jim Brows and
Speaker 1: chiropractors and personal trainers on YouTube and social media, when
Speaker 1: they give these advice about these peptides, they are giving,
Speaker 1: make no bones about it, they are giving straight up
Speaker 1: medical advice with zero medical training. And it in my mind,
Speaker 1: you know, medical doctor bums me out. But it really
Speaker 1: amounts to the abating and abedding the lightest light unlicensed
Speaker 1: practice of medicine. Blah blah blah. But just just be
Speaker 1: very careful where you.
Speaker 2: Get your advice from. Here's what I would tell you
Speaker 2: if you're thinking of going that route. Okay, you, as
Speaker 2: the user of one of these drugs, knows already as
Speaker 2: much or more than the person who's selling it to you.
Speaker 2: In these circumstances, they don't know anything. You don't know.
Speaker 2: They're getting their information just like you, off of TikTok
Speaker 2: or Instagram. They're not reading the medical studies in the Lancet,
Speaker 2: so you know, or you can know easily as much
Speaker 2: or more about them. So if you're going to go
Speaker 2: this route. And I think we agree, we don't really
Speaker 2: recommend doing this. We recommend doing this through a doctor.
Speaker 2: We don't. I think we could sum up by saying
Speaker 2: that we're not saying don't do this, we're saying this,
Speaker 2: do this with some caution, and do it carefully, and
Speaker 2: do it as part of a sensible program. These drugs
Speaker 2: do have a role, and they're frankly amazing, but do
Speaker 2: it in a way that you're protecting yourself, where you're
Speaker 2: taking reasonable precautions. And if you're going to do these drugs,
Speaker 2: you have the entire knowledge of the entire medical world
Speaker 2: in your pocket, on your iPhone, Get on chat GPT,
Speaker 2: get on Google, read some stuff about it, know what
Speaker 2: you're getting into, and then if you want to do
Speaker 2: it and make an educated decision, then go to your
Speaker 2: doctor and do it appropriately so you know that you're
Speaker 2: getting the pure drug and you're being monitored, and you're
Speaker 2: doing this safely, and it's not only improving your looks,
Speaker 2: it's making you healthier instead of sick.
Speaker 1: Okay, I think that's perfect advice. And I think Chat
Speaker 1: GBT is as bad as doctor Google used to be.
Speaker 1: Chat TBT is a very good medical clinician very good.
Speaker 2: So I'm consistently blown away by it that I can
Speaker 2: basically scan like a page of lab results and go, hey,
Speaker 2: what do you think of this? And it nails it.
Speaker 1: Yeah, it's incredible. Well, I think that was fun, really important,
Speaker 1: and I hope people appreciate that. We're not saying it's
Speaker 1: anarexia nervosa. It's not a psychiatric disorder. It's just a
Speaker 1: misuse of a very important, historic drug that really needs
Speaker 1: to be looked at very carefully and done with great caution.
Speaker 2: Right. It's like a lot of things in our industry.
Speaker 2: It's you know, most of plastic surgery is great. It
Speaker 2: becomes a problem when people take it to extremes. Yeah,
Speaker 2: you know, when you go too far. When you said
Speaker 2: when you put in fifteen hundred CC implants, it's the
Speaker 2: same thing. It's taking something that is a really powerful
Speaker 2: tool for beauty and self esteem and turning it into
Speaker 2: something potentially dangerous. So don't do it. Just use it sensibly.
Speaker 1: Okay, Well, until next time. I hope you all enjoyed that,
Speaker 1: and we'll see you, hopefully very soon.